Nursing Chapter 1

Nursing as a Profession

• To act professionally, nurses must use critical thinking skills, administer quality patient-centered care, and be responsible and accountable.
• They must understand the scope of professional nursing practice and its influence on patients, their families, and communities.

Science and Art of Nursing Practice

• Nursing requires current knowledge and practice standards, an insightful and compassionate approach, and critical thinking and clinical judgment.

Benner's Novice to Expert Model

• Novice: Beginner nurse student with no nursing experience.
• Advanced Beginner: Some level of experience, possibly only observational.
• Competent: A nurse with 2-3 years of experience in the same clinical position.
• Proficient: A nurse with more than 2-3 years of experience.
• Expert: A nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem.

American Nurses Association (ANA)

• Nursing: Scope and Standards of Practice includes standards of professional nursing practice, standards of professional performance, and a code of ethics.
• The Nursing Process is a model for clinical decision making, consisting of:
• Assessment
• Diagnosis
• Outcomes identification
• Planning
• Implementation
• Evaluation
• ANA Standards of Professional Performance include:
• Ethics
• Advocacy
• Respectful and equitable practice
• Communication
• Collaboration
• Leadership
• Education
• Scholarly inquiry
• Quality of practice
• Professional practice evaluation
• Resource stewardship
• Environmental evaluation

Professional Responsibilities and Roles

• Autonomy and accountability
• Caregiver
• Advocate
• Educator
• Communicator
• Manager

Career Development

• Clinician
• Advanced practice registered nurses (APRNs):
• Clinical nurse specialist
• Nurse practitioner
• Certified nurse-midwife
• Certified registered nurse anesthetist
• Nurse educator
• Nurse administrator
• Nurse researcher

Historical Influences

• Florence Nightingale:
• Established first nursing philosophy (Nursing Theory) based on health maintenance and restoration.
• Organized first program for training nurses.
• First practicing epidemiologist.
• Improved sanitation in battlefield hospitals.
• Practices remain a basic part of nursing today.
• Other historical figures:
• Clara Barton
• Dorthea Lynde Dix
• Mary Ann Ball (Mother Bickerdyke)
• Harriet Tubman
• Mary Mahoney
• Isabel Hampton Robb
• Lillian Wald
• Mary Brewster

Twentieth Century Developments

• Movement toward scientific, research-based practice and defined body of knowledge.
• Nurses assumed expanded roles.
• Key events:
• 1906: Mary Adelaide Nutting moved nursing education into universities.
• 1920s: Nursing specialization began.
• 1990: ANA established Center for Ethics and Human Rights.
• 1994: University of Washington Medical Center became the first Magnet-designated organization.

Twenty-First Century Developments

• Nurses are revising nursing practice and school curricula to meet the ever-changing needs of society.
• Key challenges:
• Aging population
• Cultural diversity
• Bioterrorism
• Emerging infections
• Disaster management

Contemporary Influences

• Importance of nurses' self-care
• Health care reform and costs
• Demographic changes
• Medically underserved populations

Trends in Nursing

• Evidence-based practice
• Quality and Safety Education for Nurses (QSEN)
• Impact of emerging technologies
• Genomics
• Public perception of nursing